Gendered perspectives on women’s anabolic–androgenic steroid (AAS) usage practices

Abstract

Background The masculinizing effects from anabolic–androgenic steroid (AAS) appear to be different between men and women, leading to calls for more gender-specific information regarding women and AAS use. This study sought to gather perspectives from both men and women on the unique challenges surrounding women’s use of AAS, irrespective of their personal use. Secondly, the study interrogated how women’s AAS practices differ from those of men specifically. Methods The data presented in this paper come from a subsample of participants who participated in a larger study investigating women and performance and image enhancing drug (PIED) use in Australia. Participants were included in the current analysis if they were: (i) males or females who competed with or coached female strength athletes using AAS and (ii) female and male strength athletes who used AAS. The final sample comprised 21 participants of which there was a proportion of males (n = 7) and females (n = 7) using AAS. Results Women’s choices in AAS selection were predominantly around oral compounds (e.g. Oxandrolone) as well as other PIEDs (e.g. Clenbuterol). Some women report the use of injectable AAS represents a change in the profile of the typical female user as it reportedly comes alongside drastic physical and psychological changes. Conclusions The unique challenges facing women who use AAS are largely isolation and stigma, with little evidence-based practice or education being available to them online or through peer-groups. Future work may consider piloting harm reduction strategies that may be co-designed with this group.

Beyond the law: Exploring the impact of criminalising anabolic–androgenic steroid use on help-seeking and health outcomes in Australia

“…As components of larger research projects (Dunn, Piatkowski, Lamon, et al, 2023; Dunn, Piatkowski, Whiteside, et al, 2023; Piatkowski, Hides, et al, 2022; Piatkowski, Lamon, et al, 2023; Piatkowski, Neumann, et al, 2023), a series of semi-structured interviews were performed with several subsamples of individuals regarding AAS, including users and healthcare providers. The present study draws on a subset ( N = 24) of these.…”

Understanding muscularity, physique anxiety, and the experience of body image enhancement among men and women: A mixed‐methods study

“…Despite the existing literature indicating gender differences in SPA, we hypothesised (iii) no differences would be present between genders, given the shift in ideals (Uhlmann et al, 2020). Given the established muscular ideal among men (Bergeron & Tylka, 2007;Karazsia & Crowther, 2010;Piatkowski et al, 2022;Stratton et al, 2015) and emergence among women (Robinson et al, 2017;Uhlmann et al, 2020), as well as use of enhancement strategies by both (Abrahin et al, 2017;Piatkowski, Lamon, et al, 2023;Piatkowski, Neumann, et al, 2023), the qualitative component of this study sought to explore the body image experiences of a mixed gender sample of men and women who engaged in risky body enhancement strategies, specifically PIED use. We aimed to capture and articulate the narrative regarding the role body image concerns had in their lives more broadly, and the way they managed these concerns.…”

“…These types of evaluations and upward comparisons have been shown to occur more frequently for men who lift weights and are frequently exposed to muscular and lean body image ideals such as via peers and social media (Piatkowski et al, 2020(Piatkowski et al, , 2021Rohlinger, 2002;Vokey et al, 2013), as well as through contemporary fitness microcelebrities and gurus (Gibbs & Piatkowski, 2023). Recent research has revealed that women who engage in body enhancement strategies such as AAS use for muscularity also experience mental health concerns linked to their bodies (Piatkowski, Lamon, et al, 2023;. It is therefore likely that women who are regularly involved in weight training may also experience heightened instances of upward comparison and, consequently, body image concerns centred on muscularity which may eventuate in SPA or enhancement behaviours.…”

Navigating Risks and Reducing Harm: A Gendered Analysis of Anabolic–Androgenic Steroid Users Within the Risk Environment Framework

“…Further health risks for women include voice deepening, excessive growth of facial and body hair, alopecia, disturbances in menstrual patterns, clitoral enlargement, and diminished breast size (Börjesson et al, 2016;Gruber & Pope, 2000;Ip et al, 2010). Although the usage of AAS among women is increasingly recognized (Abrahin et al, 2017;Havnes et al, 2021b;Piatkowski, Lamon, et al, 2023;Scarth et al, 2022), there remains a significant dearth of knowledge regarding women who use AAS.…”